SLEに対するアフェレシスの有用性の検討(<特集>21世紀のアフェレシス-作用機序と臨床効果のエビデンス)

概要

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Clinical observations with extracorporeal therapy named apheresis for systemic lupus erythematosus(SLE)have been published over the past 20 years. Many authors described the beneficial effects of this method on life-threatening organ involvements in lupus patients, but failed to define the clinical efficacy obtained by apheresis alone. Since it is evident that circulating macromolecules, such as immune complex, cryoglobulin, antibody to double stranded DNA, and other toxic autoantibodies, are quickly removed by therapeutic apheresis, it could be evaluated as one of the potent tools for SLE. Contrary to this, a double-blind randomized trial failed to define the clinical significance of this type of therapy in the long-term outcome of patients with lupus nephritis. One important point remained to be discussed:many influential factors, such as the great variety in histological severity, heterogeneity of multiorgan involvements, and conditions of maintenance therapy, affect the deterioration of renal function from the aspect of long-term prognosis. To resolve the problems discussed above and to establish the clinical usefulness of apheresis, multicenter trials should be undertaken in future.
日本アフェレシス学会の論文
2001-02-28